On Our Radar

Breast Cancer Detection, Treatment, and the Bottom Line

That’s the chance the average woman has of developing breast cancer within her lifetime.

And that’s the number a new 3D imaging technology is working to combat.

With 12,000 mammography systems nationwide and 11,000 of those already converted from analog to digital, the switch to 3D in your area could be just on the horizon.

Glenn P. Muir, the Executive Vice President and Chief Financial Officer of Hologic (HOLX), the only company with FDA approval for a new kind of breast cancer detection technology known as tomosynthesis, says the switch to 3D has been more than six years in the making, and it’s beginning to roll out in hospitals across the country.

“What’s exciting is we have a population of aging 2D at the same time we have a phenomenal, exciting technology that can change the way mammographies are taken here in the U.S,” he said. “We believe it’s going to accelerate the adoption, because hospitals, not because they have to, but because they’ll want to offer the best possible technology for women.”

Of course, with new technologies come new expenses. And like any other state-of-the-art piece of equipment, tomosynthesis technology is not without its added costs. The new equipment goes for about $400,000. Muir said that while expensive, the cost to upgrade from 2D imaging from 3D isn’t as expensive as it was to upgrade to 2D from analog imaging. That’s because with this upgrade, hospitals don’t have to worry about the cost of adding new infrastructure and connectivity for the new equipment. Since 2D imaging works in much the same way 3D works, it’s a relatively easy upgrade to accommodate.

Baxter Regional Medical Center is one of the early adopters of the new tomosynthesis technology and was among the first to begin using it on patients. Ron Peterson, President and Chief Executive Officer, said for his facility, the cost of having state-of-the art equipment shouldn’t prevent patients from receiving the highest quality of care. That’s why Baxter offers the 3D imaging at no additional cost to patients. His doctors are able to catch dangerous masses six months to a year earlier than they could with 2D – sometimes with the ability to remove potentially cancerous materials from the body with just a biopsy.

“Right now, we do not charge our patients any more for 3D, so, they’re not getting an additional charge,” Peterson said. “We feel like that’s what we need to do at this time. But we also know, on the radiologists’ side, it takes about twice as long or even sometimes a little longer to read the films because instead of reading two or three films, you’re going through 1 mm slices (which can add up to hundreds of images at a time).”

But not all facilities implementing 3D imaging are able to offer the services without passing the added cost onto patients. And because of that, Hologic and other members of the medical community are working to make the services more affordable for both hospitals and their patients.

To combat the elevated cost, Hologic is looking to Congress for help adding more accurate CPT codes that can be assigned to the procedure at the time of billing. Despite the effort, Muir said, at this point, it’s not a losing battle for hospitals offering 3D services. Those facilities are still reimbursed, but at the 2D rate until, he hopes, new CPT codes will be added.

Still, Peterson doesn’t see the higher cost outlay for his facility as a negative.

“We’re getting reimbursed at the 2D rate,” he said. “But what it means for us is we made the investment in the 3D and it’s because we believe the technology is that much better. It was worth our expense to provide that care for our patients.”

Looking further down the line, both Muir and Peterson agree the widespread adoption of 3D imaging can only help the medical community. Of about 38 million mammograms performed in the U.S. on an annual basis, about four million are unnecessarily called back for further tests and exams because the findings on their 2D scans were inconclusive or hard to read.

Peterson said the savings not only adds up to less anxiety for four million women in the U.S., but also to the health-care system’s bottom line because those women are not returning to medical facilities for more workups, diagnostics, x-rays, and further exams.

“The savings is in the treatment. You’re catching (cancer) earlier; your treatment is not as invasive as it would be. So, A) It’s easier and faster the patient, which is the most important thing. But B) it also saves the system costs. We’ve had surgeons tell us, ‘Wow, I can’t believe you’re catching things this small that early.’”

At Baxter, a facility that not only offers 3D, but uses the technology on every mammography patient who walks through the door, Peterson said already the hospital has seen a 10% increase in the number of women who come in for mammograms. And he attributes that strictly to the advancement in technology, which he said can help the hospital give treatment to more women.

“The mammography is the screening tool, that’s where you get the broadest number of patients, but that’s not necessarily where you get your return on investment. You get (that) as patients come through the system as they need more tests, surgery, radiation therapy, and chemotherapy, whatever it is to treat the cancer.”

Right now, 3D mammography is available in 46 states and the District of Columbia. Of the nearly 12,000 mammography systems in the US, more than 300 now offer 3D services.